Pre-Billing Specialist (Office, Billing, Audit) - HomeCare

About the role

The Pre-Billing Specialist is responsible for reviewing and validating clinical documentation and billing data within the Homecare Homebase (HCHB) system prior to claim submission. This role ensures compliance with Medicare, Medicaid, and other Commercial payer requirements, helping to prevent billing errors and reduce denials. This position works closely with clinical, administrative, and billing teams to ensure accurate and timely revenue capture.

Responsibilities

• Review patient charts in HCHB to ensure all required documentation is complete and compliant before billing.
• Validate visit frequencies, orders and care plans against billing requirements.
• Affirm that all disciplines have signed and locked notes and that visits are properly scheduled and documented.
• Maintain up-to-date knowledge of payer guidelines and regulatory changes to ensure billing readiness for Medicare, Medicaid, and commercial payers, while also assisting in training staff on documentation and billing compliance best practices.
• Identify and resolve discrepancies or missing documentation that could delay billing, collaborating with clinical staff to obtain corrections or additional information as needed.

Qualifications

• High school diploma, Bachelor’s Degree Preferred
• Experience: 1 Year of Administrative Healthcare Experience, 2 years of experience in home health billing, auditing, or clinical documentation review
• Knowledge, Skills and Abilities: Strong working knowledge of auditing or clinical documentation review, good communication and excellent attention to details and organizational skills, autonomy, assertiveness, flexibility and cooperation in performing job responsibilities